Molecular imaging for theranostics in gastroenterology: one stone to kill two birds

Abstract

Molecular imaging in gastroenterology has become more feasible with recent advances in imaging technology, molecular genetics, and next-generation biochemistry, in addition to advances in endoscopic imaging techniques including magnified high-resolution endoscopy, narrow band imaging or autofluorescence imaging, flexible spectral imaging color enhancement, and confocal laser endomicroscopy. These developments have the potential to serve as "red flag" techniques enabling the earlier and accurate detection of mucosal abnormalities (such as precancerous lesions) beyond biomarkers, virtual histology of detected lesions, and molecular targeted therapy-the strategy of "one stone to kill two or three birds"; however, more effort should be done to be "blue ocean" benefit. This review deals with the introduction of Raman spectroscopy endoscopy, imaging mass spectroscopy, and nanomolecule development for theranostics. Imaging of molecular pathological changes in cells/tissues/organs might open the "royal road" to either convincing diagnosis of diseases that otherwise would only be detected in the advanced stages or novel therapeutic methods targeted to personalized medicine.

Keywords: Imaging mass spectroscopy; Individualized medicine; Molecular imaging; Spectrum analysis, Raman; Theranostics.

Fig. 1

Molecular imaging: simple but precise. When endoscopists find suspicious lesions or have information before endoscopy, they simply inject the appropriate nanomedicine dye for molecular imaging and then just switch the optimal light to conclude the observation.

Fig. 2

Molecular imaging for theranostics: one stone to kill two or three birds. These precise and predictive molecular imaging technologies might enable molecular targeted therapy and allow understanding the underlying pathogenesis far beyond biomarkers could.